中国药物警戒 ›› 2026, Vol. 23 ›› Issue (1): 101-104.
DOI: 10.19803/j.1672-8629.20250388

• 安全与合理用药 • 上一篇    下一篇

183例抗精神病药致锥体外系反应报告分析

兰晓倩1,2, 庄红艳1,2, 李鹏飞1,2,*   

  1. 1首都医科大学附属北京安定医院药事部,国家精神心理疾病临床医学研究中心,精神疾病诊断与治疗北京市重点实验室,北京 100088;
    2首都医科大学人脑保护高精尖创新中心,北京 100069
  • 收稿日期:2025-06-16 出版日期:2026-01-15 发布日期:2026-01-15
  • 通讯作者: *李鹏飞,男,硕士,主任药师,医院药学。E-mail: lee-pf@ccmu.edu.cn
  • 作者简介:兰晓倩,女,硕士,主管药师,临床药学。
  • 基金资助:
    国家自然科学基金资助项目（81904120）; 北京市医院管理中心“扬帆”计划医工结合培育项目（YGLX202537）

Clinical Characteristics of 183 Reports of Extrapyramidal Symptoms Induced by Antipsychotics

LAN Xiaoqian1,2, ZHUANG Hongyan1,2, LI Pengfei1,2,*   

  1. 1Department of Pharmacy, Beijing Anding Hospital Affiliated to Capital Medical University, National Medical Research Center for Mental Disorders & Beijing Key Laboratory for Diagnosis and Treatment of Mental Disorders, Beijing 100088, China;
    2Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
  • Received:2025-06-16 Online:2026-01-15 Published:2026-01-15

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摘要： 目的 探讨抗精神病药致锥体外系反应（EPS）的临床特点,比较各种抗精神病药致EPS的风险,为抗精神病药的药品不良反应监测和临床合理用药提供参考。方法 回顾性分析首都医科大学附属北京安定医院2004年1月1日至2024年12月31日上报至国家药品不良反应监测网络的抗精神病药引起的EPS报告183例,分析患者的年龄、性别、药品不良反应发生时间、涉及药品、EPS临床表现、转归等,以各药致EPS例数与用药频度（DDDs）比值（n/DDDs）为指标,比较各药物引起EPS的风险。结果 纳入患者共计183例,18~40岁103例（56.28%）,以青壮年居多;EPS占比最多的临床类型为类帕金森症;诱发EPS风险最高的典型抗精神病药（FGAs）是氟哌啶醇注射液和癸酸氟哌啶醇注射液,非典型抗精神病药（SGAs）是注射用利培酮微球、棕榈酸帕利哌酮注射液、齐拉西酮片、帕利哌酮缓释片和利培酮片/口服液;EPS潜伏期少则数小时,多则数年。结论 SGAs和FGAs引起的EPS应引起临床重视,抗精神病药用药全程应密切监测EPS,以确保患者用药安全。

关键词: 抗精神病药, 氟哌啶醇注射液, 癸酸氟哌啶醇注射液, 注射用利培酮微球, 棕榈酸帕利哌酮注射液, 用药频度, 锥体外系反应, 药品不良反应

Abstract: Objective To explore the clinical characteristics of antipsychotic drug-induced extrapyramidal symptoms (EPS) in order to provide a reference for adverse reaction monitoring of antipsychotic drugs and for rational use of drugs. Methods All EPS reports associated with antipsychotics submitted to the National Adverse Drug Reaction Monitoring Network by Beijing Anding Hospital in 2004—2024 were retrospectively collected (n=183). Patients’ demographic data, clinical manifestations, causative drugs, latency period of adverse reactions, interventions and outcomes were analyzed. The risk of EPS induced by different drugs was compared using the ratio of the number of EPS cases (n) to the defined daily doses (DDDs) for each drug (n/DDDs). Results Among the 183 cases, Patients were predominantly young adults ages 18 to 40 (56.28%). Parkinsonism was the prevalent clinical manifestation of EPS. Among the first-generation antipsychotics (FGAs), haloperidol injection and haloperidol decanoate injection posed the highest risk to EPS. Among the second-generation antipsychotics (SGAs), risperidone microspheres for injection, paliperidone palmitate injection, ziprasidone tablets, risperidone tablets/oral solution, and paliperidone extended-release tablets were associated with the highest risk. The latency period for EPS ranged from hours to years. Conclusion EPS induced by both SGAs and FGAs deserves equal clinical attention. Close monitoring of EPS throughout antipsychotic treatment is essential to safety and effectiveness of medications.

Key words: Antipsychotics, Haloperidol Injection, Haloperidol Decanoate Injection, Risperidone Microspheres for Injection, Paliperidone Palmitate Injection, Defined Daily Doses, Extrapyramidal Symptoms, Adverse Drug Reaction

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